There is something very satisfying about a well fitting denture.

I am joined by our resident Dental Student, Emma Hutchison, to demystify removable prosthetics.

https://youtu.be/1hQGjKUa6MUWatch PS009 on YoutubeWhich joint position should we use for dentures? Is this important?

How do you calculate the freeway space?

What are we actually recording during a Wax Jaw Registration for complete dentures?

Don’t miss the special exam revision notes on Removable Pros available exclusively in the Protrusive Guidance app! (Join the free Students Section)

Need to Read it? Check out the Full Episode Transcript below!

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If you love this episode, check out PDP162 – Occlusion for Complete Dentures

Click below for full episode transcript:Jaz's Introduction: I think we all remember that phase at dental school where we were just confused by everything related to dentures. It was especially confusing because dentures are kind of like one of the first things you do as you're a dental student. So to you it felt like being thrown in the deep end anyway.

Jaz’s Introduction:For many of us the denture confusion lives on and continues throughout our career. Hopefully with some of the older episodes in Protrusive we managed to make dentures more tangible. And I myself have been enjoying doing some cobalt chrome dentures, something I didn’t get to do much during dental school. But today in this Protrusive Students Section, and I mean students lightly because this whole segment, the Protrusive Students Series, whilst we release some revision notes for students every time we release an episode, what we discover here is revision.

Sometimes good to revise topics, go back to basics, so if you’re a young dentist or revisiting back into dentistry, or at any stage of being a dental student, this episode and all of the series of protrusive students should be relevant to you. Especially one we did a while ago about adhesive dentistry for beginners.

Lots of qualified dentists said how much they enjoyed that one because it was nice to just go back to basics. In this one, once again with our protrusive student Dr. Emma Hutchison, she asked me about all things that confuse her as a student when it comes to dentures. And because she’s relatively new to clinic, Most of the questions he asked was related to complete dentures.

So I hope you enjoyed this recap and this revision on the different stages of complete dentures. What are we actually trying to achieve in the various stages and what is important and what’s not important? Hope you enjoy and I’ll catch you in the outro.

Main Episode:Emma Hutchison, welcome again to the Protrusive Student section. This time we’re going to cover removal. But just tell us, we’re recording this way in advance because we don’t want to interfere with your exams and stuff. How are you getting on? What’s your last few weeks been like?

[Emma]Yeah, the last week I’ve only seen one patient, which was actually my flatmate, and didn’t need anything done. And so he just got a scaling polish, a bit of PMPR, and that was him really. So nothing too exciting in terms of patients, but just I’ve got my exam dates now, so it’s really becoming real, so just keeping my head down and getting through lectures and really starting to study now, so.

[Jaz]What kind of learner are you, Emma? You know there’s different types of learners and stuff, I won’t give you any ideas, just in terms of self discovery, how do you like to learn?

[Emma]I’d say I need to listen to things, I need to be told by someone who’s talking to me, and I need to be able to translate that into something that I can understand myself, so in my notes. That I make and that I’ve shared with people. That’s all come from listening to lectures and watching these lecturers live, like I need to hear it. I’m not too good with just reading things off of a slide. I need to be there, whether it’s a lot of our lectures are pre recorded. So yeah, very audio for me, listening to it and then putting that into something that makes sense to me on paper. And then I revise from that, really.

[Jaz]I’m very much the same. When I was at dental school, very much audio based. Now back then, we didn’t have, it was everything was face to face, right? There was no like a watches on demand thing back when I was a student. However, I used to have this software on my iPad were a newish thing then.

And so I had the software called SoundNote. And so I’d be able to make my notes and it’s recording the audio at the same time. Anywhere I click on the notes, it’ll take me to that relevant part of audio. That was instrumental for me. That was really a big help. I’m also someone who likes to write and make notes. And just like you, make something make sense in my own language, in my own way. I feel like you said that.

[Emma]Yeah, definitely. Like, you can say whatever you want to me, but I need to put it into a context that makes sense for me. And that’s what I work from. Yeah, yeah, definitely. Make it make sense for me. Yeah, definitely.

[Jaz]Let’s make removable prosth sense for you as much as we can in the next 20 or so minutes. As a student’s perspective, I know you’ve had a few patients when it comes to removable prosth. So, come at me, what’s on your mind, Emma?

[Emma]So the first question I’ll ask, probably because it’s the biggest, and I know you’ve done episodes on this before, I know you’ve done episodes on this before, and it’s all about a bite reg. If we’re in the locker room getting changed and you’re talking to your friends, what do you have today? I’m on Prosth Clinic. If someone says, oh, I’ve got a bite reg in, you say, God bless you, good luck. Because it just seems like absolute witchcraft, I don’t know what’s going on. So just a bit, quite basic, what am I trying to get out of that appointment?

Maybe some steps to help me along the way. But that’s definitely from a few people that I’ve told about what we’re doing with protrusive students. They say, can you please make a bite reg episode, because I don’t know what I’m doing.

[Jaz]I love it. I love this because it’s bringing back memories of me playing. So I was in third year. I was playing FIFA with my flatmate in fifth year. So we’re playing FIFA. And I had my denture patient in for a bite reg. And I was kind of like revising. So what am I checking for again? Like what am I doing? I remember having the controller in my hand. I’m like asking these questions.

I remember this very vividly, actually. So, to answer this question, and I’d love to make it tangible for all, firstly a disclaimer, I am no removal pros guru. There are, in the top five things I’m good at in dentistry, removal pros is not in them, just because I haven’t done enough of it. Even though I did quite a lot of complete dentures and stuff during my time as a DCT, it was as a restorative dentist DCT.

That was pretty good. But that’s been some years now, but I’m not scared of dentures and I’m happy to, I quite enjoy the cases when they come through, but they don’t seem to come through as much anymore, but I’m definitely happy to answer that question because that’s related to occlusion and we can definitely do that.

So first thing to distinguish Emma is, are we talking dentures without teeth? Or are we talking partially dentate? We’ll explore both of them, but which one would you like me to go first?

[Emma]Complete dentures, yeah. Dentureless patients.

[Jaz]Okay.

[Emma]If we can.

[Jaz]Of course we can. All a bite registration is, these wax jaw registration rims, is where the technician has to put some teeth. They need to know how the teeth need to meet together when the patient bites together. They need to know how big to make the teeth, how big to make the incisors, and they need to know where the canines go, where the centrals go. They can’t guess that at all. They need the bite registration. The bite registration is giving that information.

And essentially, when they put the jaw registration on like an articulator, right? So they can actually mimic the, some kind of movements and do up and down. And sometimes they may get ambitious and do side to side, right? What we’re trying to do with any articulator is recreate the patient’s jaw on the tabletop.

That’s exactly it. So there’s a number of things that we’re trying to record when it comes to a complete denture wax jaw registration. And essentially all of it stems that the ultimate aim is how can we essentially give the maxilla and mandible relationship to the technician. So when they have it on their table, how far it’s apart and how big you want the denture, how much you want the OBD on their articulator is the same as on the patient, essentially.

That’s at the crux, that’s what it is. When you get back your upper and lower wax rims, okay, you’ve got to first try it in because the preceding appointments are so important, the primary impression, the secondary impression. If something hasn’t gone quite right in that, you might ...